Elderly patients with cognitive impairments on an ambulance care

Abstract

BACKGROUND: Cognitive impairment is one of the most common geriatric syndromes that occur in the elderly. Dementia is a severe cognitive disorder that results in the professional, social, and functional impairment and gradual loss of independence. However, in most cases, the stage of dementia is preceded by a long period of non-dementia cognitive impairment. In this regard, one of the priorities of public health is to identify potentially reversible forms of dementia and cognitive impairment in the early stages.

AIM: To assess demographic characteristics, co-morbidities and factors that are associated with cognitive impairment in adults aged 65 years and over and to determine the prevalence of cognitive disorders in aging population.

MATERIALS AND METHODS: cross-sectional study included all patients aged 65 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 in Saint Petersburg. Measurements: the Montreal cognitive assessment test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, blood pressure measurement, a medication review and blood tests (complete blood count, lipids, hormones, glucose, ALT, AST and creatinine).

RESULTS: The prevalence of mild cognitive impairment was 62.9 % (95 % CI 56-70), severe cognitive impairment — 8.2 %. We detected that hypertension, stroke, sleep disorders, subjective memory complaints and symptoms of depression were identified as factors associated with CI after adjustment for covariates. Hypertension and depression were related with cognitive impairment (p < 0.05). Also patients with depression scored worse in global cognition and attention function (p < 0.05). Patients with diabetes had association with a decrease in abstraction function (p = 0.02). Low hemoglobin levels were related with poor global cognition and memory impairment (p < 0.01). Beta-blocker use was significantly associated with poor global cognition and memory impairment (p < 0.01).

CONCLUSIONS: We found that elders have a high prevalence of cognitive disorders. We also demonstrated association between co-morbidities and factors as hypertension, anemia, diabetes, depression and administration of beta-blockers with poor cognitive performance in the elderly.

Keywords

elderly / cognitive disorders / dementia / mild cognitive impairments / risk factors / cognitive assessment / MoCA

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Bogdanova T.A., Turusheva A.V., Frolova E.V., Logunov D.L.